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The history of psychiatric institutions and the psychiatric profession is by now familiar: asylums multiplied in nineteenth-century England and psychiatry established itself as a medical specialty around the same time. We are, however, largely ignorant about madness at home in this key period: what were the family’s attitudes toward its insane member, what were patient’s lives like when they remained at home? Until now, most accounts have suggested that the family and community gradually abdicated responsibility for taking care of mentally ill members to the doctors who ran the asylums. However, this provocatively argued study, painting a fascinating picture of how families viewed and managed madness, suggests that the family actually played a critical role in caring for the insane and in the development of psychiatry itself. Akihito Suzuki’s richly detailed social history includes several fascinating case histories, looks closely at little studied source material including press reports of formal legal declarations of insanity, or Commissions of Lunacy, and also provides an illuminating historical perspective on our own day and age, when the mentally ill are mainly treated in home and community.

List of IllustrationsAcknowledgmentsIntroduction: Psychiatry in the Private and the Public Spheres

1. Commissions of Lunacy: Background, Sources, and Content2. The Structure of Psychiatric Practice3. The Problems of Liberty and Property4. Managing Lunatics within the Domestic Sphere5. Destabilizing the Domestic Psychiatric Regime6. Public Authorities and the Ambiguities of the Lunatic at Home

ConclusionAppendixNotesBibliographyIndex

Akihito Suzuki is Professor of History in the School of Economics at Keio University, Japan.

“Ten years in the making, Akihito Suzuki’s new book has been well worth the wait . . . It is a stimulating and thoughtful book that adds greatly to our picture of insanity in 19th-century England.”—Jama

“Madness at Home is a richly detailed and important contribution to our understanding of 19th century psychiatry. It is of interest to both professional historians and clinical practitioners with an interest in the history of their profession. Those teaching courses in the history of psychiatry will find it difficult to cover their topic without reference to this work.”—Tony O’Brien Metapsychology Online Review

“Suzuki’s book is a landmark study in the history of madness. Its sophisticated scholarship and challenging arguments should fundamentally transform the way we approach the history of madness in the Victorian era.”—David Wright Victorian Studies

“A brilliant and profoundly original book, one of the most important contributions to the history of psychiatry in the past decade.”—Andrew Scull, co-author of Customers and Patrons of the Mad-Trade: The Management of Lunacy in Eighteenth-Century London

"Suzuki's sophisticated and revealing account is a persuasive reminder that the family's recent involvement in mental health care policy-making is nothing new. As he shows, in more ways than one, madness does indeed begin at home.”—Ian Dowbiggin, author of A Concise History of Euthanasia: Life, Death, God and Medicine

“Suzuki beautifully composes a portrait of domestic care for the insane in nineteenth century England. In this text, Suzuki skillfully and elegantly explores the importance of family relationships in the identification, treatment and re-integration of the insane. Suzuki elucidates the web of relationships which marked out the private and public worlds of insanity in the long nineteenth century and captures the interplay of different actors who were engaged in the care, treatment, and disposal of those considered mad.”—Joseph Melling, author of The Politics of Madness: Insanity and the English Asylum, 1845-1914